Impact of liver cirrhosis, the severity of cirrhosis, and portal hypertension on the outcomes of minimally invasive left lateral sectionectomies for primary liver malignancies.
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Coelho Fabricio Ferreira, Herman Paulo, Kruger Jaime A P, Wu Andrew G R, Chin Ken-Min, Hasegawa Kiyoshi, Zhang Wanguang, Alzoubi Mohammad, Aghayan Davit L, Siow Tiing-Foong, Scatton Olivier, Kingham T Peter, Marino Marco V, Mazzaferro Vincenzo, Chiow Adrian K H, Sucandy Iswanto, Ivanecz Arpad, Choi Sung Hoon, Lee Jae Hoon, Gastaca Mikel, Vivarelli Marco, Giuliante Felice, Ruzzenente Andrea, Yong Chee-Chien, Dokmak Safi, Fondevila Constantino, Efanov Mikhail, Morise Zenichi, Di Benedetto Fabrizio, Brustia Raffaele, Valle Raffaele Dalla, Boggi Ugo, Geller David, Belli Andrea, Memeo Riccardo, Gruttadauria Salvatore, Mejia Alejandro, Park James O, Rotellar Fernando, Choi Gi Hong, Robles-Campos Ricardo, Wang Xiaoying, Sutcliffe Robert P, Pratschke Johann, Lai Eric C H, Chong Charing C N, D'Hondt Mathieu, Monden Kazuteru, Lopez-Ben Santiago, Liu Rong, Ferrero Alessandro, Ettorre Giuseppe Maria, Cipriani Federica, Cherqui Daniel, Liang Xiao, Soubrane Olivier, Wakabayashi Go, Troisi Roberto I, Yin Mengqiu, Cheung Tan-To, Sugioka Atsushi, Han Ho-Seong, Long Tran Cong Duy, Fuks David, Abu Hilal Mohammad, Chen Kuo-Hsin, Aldrighetti Luca, Edwin Bjørn, Goh Brian K P, International Robotic and Laparoscopic Liver Resection study group investigators are coauthors of this study
Аннотация
METHODS: This was an international multicenter retrospective analysis of 1,526 patients who underwent minimally invasive left lateral sectionectomies for primary liver malignancies at 60 centers worldwide between 2004 and 2021. In the study, 1,370 patients met the inclusion criteria and formed the final study group. Baseline clinicopathological characteristics and perioperative outcomes of these patients were compared. To minimize confounding factors, 1:1 propensity score matching and coarsened exact matching were performed.
RESULTS: The study group comprised 559, 753, and 58 patients who did not have cirrhosis, Child-Pugh A, and Child-Pugh B cirrhosis, respectively. Six-hundred and thirty patients with cirrhosis had portal hypertension, and 170 did not. After propensity score matching and coarsened exact matching, Child-Pugh A patients with cirrhosis undergoing minimally invasive left lateral sectionectomies had longer operative time, higher intraoperative blood loss, higher transfusion rate, and longer hospital stay than patients without cirrhosis. The extent of cirrhosis did not significantly impact perioperative outcomes except for a longer duration of hospital stay.
CONCLUSION: Liver cirrhosis adversely affected the intraoperative technical difficulty and perioperative outcomes of minimally invasive left lateral sectionectomies.